Infant death rates continue to fall

There were fewer sudden infant death
syndrome deaths (SIDS) in 1997 than previous years, though
total infant deaths have moved downwards only slightly
according to the latest provisional figures from the
Ministry of Health.

Chief Advisor, Child and Youth Health,
Dr Pat Tuohy said each one of the statistics represents a
sad loss for many families and friends. Research and health
promotion and education efforts continue to try and further
reduce these deaths.

"These efforts are now helped by
better information on the circumstances of the death and
more consistent autopsy protocols," Dr Tuohy said.

Its
becoming clearer that fewer infants are dying from SIDS as
more accurate diagnoses and information emerges.

"Some of
the fall is related to reclassification of SIDS as other
diagnoses, particularly accidental suffocation, as better
information is made available to pathologists and coroners".
As well as some reclassification from SIDS to accidental
asphyxia, the Infant death rate has not fallen as much as
expected because of an increase in deaths from meningitis in
1997".

"There has been a sharp fall in numbers of babies
recorded as dying from SIDS - in 1997 81 babies died from
this condition down from 109 in 1996. Most of the reduction
in SIDS was due to lower rates among Maori and Pacific
infants. Pacific rates have halved and Maori rates have
dropped by 25%," Dr Tuohy said.

"This is encouraging news,
but it has to be tempered by the knowledge that two years
data is too little to confirm a trend".

1996 and 1997 data
for Maori and Pacific people can't be compared with pre 1995
data because of changes in the way ethnicity has been
categorised.

Nontheless this information is a welcome
finding and helps support the excellent work done by Maori
and Pacific SIDS groups who have been working for many years
to reduce SIDS in their communities, Dr Tuohy said.

This
improvement follows a gradual reduction in SIDS deaths after
the dramatic drop in 1990 due to the New Zealand Cot death
prevention campaign.

Perinatal deaths (deaths that occur
from 20 weeks of pregnancy until the first week after
delivery) are believed to have increased due to better
reporting over the last two years.

"There is considerable
work done by many individuals and health providers in New
Zealand to reduce these deaths. Better information is an
important first step to ensuring our efforts are directed in
the right direction," Dr Tuohy said.

The provisional 1997
figures are corrrect for total infant deaths, but there
remain four deaths which have yet to have the cause of death
finally determined (from post-mortem or Coroner's report),
Dr Tuohy said.

BACKGROUND INFORMATION - INFANT DEATHS
1993-1997

TOTAL INFANT DEATHSThe provisional infant
death rate in 1997 (6.7 per 1,000 livebirths) is the
sameas in 1995 but 8 percent lower than 1996
(7.3).

Note:
There are 4 infant deaths in 1997 for which a cause of death
is not yetavailable; these cases are included in
totals.

Apart from 1995, the numbers (and rates) of early
neonatal deaths remainedrelatively constant.The
numbers and rates of late neonatal (1 week to 1 month after
birth) deathsare small and should be interpreted with
caution.Numbers and rates of post-neonatal (1 month to 1
year after birth) deaths showthe greatest change.
Numbers were constant from 1993-95 but have since
fallenby 11 percent. Rates have fallen by 9
percent.

Numbers
fell by 10 percent between 1995 and 1996 and by a further 26
percent in1997. The number of SIDS deaths in 1997 was
33 percent lower than in 1995.Rates have also fallen.
The 1997 rate was 33 percent lower than in
1995.Preliminary analysis of the data indicates that
much of the reduction in SIDShas occurred in the
Southern HFA Region where numbers fell from 26 in 1995 to
6in 1997, a reduction of 77 percent.

There are
overall reductions in both SIDS and Post-neonatal deaths
(PNND).The recent reduction in SIDS is greater than the
reduction in PNND. Thissuggests that there may be an
element of diagnostic shift but numbers are smalland we
should be cautious in interpreting. Numbers of deaths coded
as being dueto 'SIDS plus another diagnosis' reduced
from 9 in 1994 to 3 in 1997 indicatinggreater certainty
about the cause of death.

More PNND were certified to
infectious and parasitic diseases in 1997 than
inprevious 4 years. This is primarily due to deaths
from
meningitis.

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